Socioeconomic status plays a crucial role in determining the health outcomes of individuals and communities. For poor communities, the outlook is not bright. In particular, low-income Asian American Pacific Islander (AAPI) women face unique challenges in their reproductive lives. When women are unable to access appropriate health care for themselves, it not only impacts them, but it also has detrimental effects on their families.
Poverty exacerbates people’s inability to access preventive services. Preventive care can identify risk factors and prevent treatable illnesses and premature deaths. It also helps promote positive health behaviors and discourages poor behaviors.
For some AAPI communities, utilizing preventive health care is not possible due to lack of access. For example, lawfully present immigrants are ineligible for Medicaid until they have been in the country for five years. In addition, immigrants do not commonly access preventive health care because it was not promoted in their home countries, says local family physician Dr. Alison Shigaki. A culture of preventive health care creates generations of healthy people and medical exams like Pap smears and mammograms become normal for families and communities. According to a National Asian Pacific American Women’s Forum (NAPAWF) report, almost 30 percent of AAPI women in the country have not had a mammogram in the past two years and nearly a quarter have not had a Pap smear within the last three years.
Sadly, there are health issues that are more prevalent in low-income AAPI communities. While NAPAWF reports the rate of cervical cancer has fallen for all major racial groups, the incidence among Asian American women remains high. Vietnamese women are five times more likely to have cervical cancer than their white counterparts and Korean women are twice as likely to be diagnosed with cervical cancer.
There is also a high occurrence of unintended pregnancies in the AAPI community. Young AAPI women access abortions at a higher rate than their white peers, likely because they have a lower utilization and access rates to contraception, says Priscilla Huang, Associate Policy Director of the Asian & Pacific Islander American Health Forum. Comprehensive and culturally appropriate sex education in public schools also plays a role in the high number of unintended pregnancies. For many young women, schools offer the best opportunities for young people to learn about health and sexuality, especially since there are cultural taboos around talking about sex.
“When you have a generation of young women who were either exposed to [comprehensive sex education] in school or learned about it from their friends,” it helps create communities where it is acceptable to talk about sexual health, says Huang.
Poor working conditions also determine health outcomes for low-income communities. For example, the National Healthy Nail Salon Alliance advocates for federal and local policies to limit the exposure of dangerous chemicals and toxins to women working in nail salons. Toluene, formaldehyde, and dibutyl phthalate, the “toxic trio” found in common nail polish products, are suspected to cause cancer, respiratory illnesses, and reproductive harm. Nail salon workers are overwhelmingly Asian immigrant women.
API communities need greater access to health services to improve the reproductive lives of women in our community. Unfortunately, the trend is heading towards limiting access rather than broadening it to create healthier communities. Take Charge, the state’s family planning Medicaid program, is at risk of being eliminated due to Washington’s budget deficit. Every year, Take Charge provides 50,000 low-income individuals access to contraception and reproductive health services, like Pap smears. Eliminating this program will have devastating effects.
The Washington State Board of Pharmacy may create another barrier to communities. The Board may modify a rule that requires pharmacies to dispense medications without discrimination or delay. If the Board chooses to change this rule, it will have a disparate impact on women who have limited access to transportation, particularly those who live in rural areas, and who may not be able to communicate with other pharmacists due to language and cultural differences.
When women are healthy, they are enabled to make positive decisions to help their families and communities.